Slovo úvodem

prof. MUDr. Ivan Rektor, CSc., FCMA, FANA, FEAN

Neurol. praxi. 2021;22(5):347  

Praktické využití zobrazovacích metod u extrapyramidových onemocnění a demence

prof. MUDr. Irena Rektorová, Ph.D.

Neurol. praxi. 2021;22(5):351 | DOI: 10.36290/neu.2021.099  

How can MRI help in diagnostics of movement disorders

MUDr. Juraj Maňkoš, doc. MUDr. Matej Škorvánek, PhD.

Neurol. praxi. 2021;22(5):352-357 | DOI: 10.36290/neu.2021.058  

Magnetic resonance imaging (MRI) is a standard part of the differential diagnostic process in movement disorders and is typically performed as the first diagnostic step after excluding drug-induced, toxic or functional origin of the disorder. This review discusses MRI findings which are rather typical for different movement disorders in combination with a specific clinical phenomenology divided into three subcategories: atypical parkinsonism, disorders associated with brain metal accumulation (iron, manganese and copper) and other movement disorders.

Evaluation of brain atrophy using visual rating scales and their clinical contribution to the early and differential diagnosis of dementia

prof. MUDr. Jan Laczó, Ph.D., prof. MUDr. Jakub Hort, Ph.D., doc. MUDr. Martin Vyhnálek, Ph.D.

Neurol. praxi. 2021;22(5):358-374 | DOI: 10.36290/neu.2021.026  

Brain imaging methods have a major clinical benefit not only for identifying potentially treatable causes or determining the vascular aetiology of dementia, but also for the differential diagnosis of neurodegenerative diseases, especially Alzheimer's disease (AN), frontotemporal dementia (FTD) and dementia with Lewy bodies (DLB) that are characterized by different patterns of brain atrophy. Visual rating scales that allow to quantify the degree of atrophy of individual brain areas have been developed for this purpose. They thus represent a useful tool for the early and differential diagnosis of neurodegenerative diseases in clinical practice. This...

Use of transcranial sonography for the diagnosis of patients with Parkinson's disease and Lewy body dementia

MUDr. Kateřina Bočková, prof. MUDr. Irena Rektorová, Ph.D.

Neurol. praxi. 2021;22(5):376-385 | DOI: 10.36290/neu.2021.042  

Transcranial sonography (TCS) is a quick, inexpensive, widely available and well applicable examination in the diagnosis of Parkinson's disease (PD) and Lewy body dementia (LBD), especially for screening in the early and prodromal stages of these diseases. Patients with PD and DLB reveal increased echogenicity of substantia nigra (SN). The SN hyperechogenicity particularly reflects excessive iron accumulation and tissue degeneration. The aim of this review is to describe the role and utility of TCS in the diagnosis of patients with PD and LBD, including a focus on their prodromal stages and differential diagnosis. In the asymptomatic period, the finding...

The role of nuclear medicine in diagnosis of Parkinson's disease, Alzheimer's disease and dementia with Lewy bodies

MUDr. Zuzana Balážová, MUDr. Jaromír Bernátek, doc. MUDr. Marek Baláž, Ph.D.

Neurol. praxi. 2021;22(5):386-392 | DOI: 10.36290/neu.2021.032  

Methods of nuclear medicine enable functional neuroimaging of various brain structures in neurodegenerative diseases. DaT scan and MIBG play a key role in differentials diagnosis of parkinsonian syndromes, in the field of movement disorders. Beta-amyloid PET imaging has a unique position in imaging of cognitive disorders. FDG PET is currently a method with predominantly research applications.

Ocrelizumab - clinical evaluation and disease progression - 6,5 years data

MUDr. Eva Recmanová

Neurol. praxi. 2021;22(5):395-397 | DOI: 10.36290/neu.2021.067  

The treatment of multiple sclerosis has undergone great progress in recent years. With the advent of new drugs, our therapeutic possibilities are expanding. The therapeutic goal remains the stability of the disease, which is monitored in clinical practice by controlling the signs of attack or disease progression. This article discusses new data on clinical activity and effects on disease progression in patients treated with ocrelizumab.

Profile of a patient with secondary progressive MS - how to identify patients that should be sent to a tertiary Center

MUDr. Hana Mojžišová, MUDr. Martin Elišák, Ph.D.

Neurol. praxi. 2021;22(5):398-402 | DOI: 10.36290/neu.2021.041  

The care of patients with secondary progressive (SP) multiple sclerosis (MS) has made a great step forward in the last year in Czech republic as a result of the approval of siponimod as the first disease modifying drug for the treatment of this form of MS. The introduction of this new treatment however increases the importance of early recognition of transition from relapse remitting to SP form of the disease, and of recognizing the active phenotype in patients where the secondary progressive form has already been identified. Since there is currently no validated biomarker that could be used to distinguish SP MS from relapse remittent form and since...

Lipoprotein(a) as risk factor for ischemic stroke

MUDr. Antónia Lacková, MUDr. Miriam Kozárová, PhD.

Neurol. praxi. 2021;22(5):404-407 | DOI: 10.36290/neu.2020.087  

Lipoprotein(a) is currently considered to be an independent risk factor for atherosclerosis. The distribution of Lp(a) levels in the population is very large and is genetically determined in up to 90 %. According to current recommendations, the level of Lp(a) should be determined at least once in a lifetime and then regularly monitored in patients with elevated Lp(a). Up to 80 % of the population has an Lp(a) level of less than 50 mg/dl (125 nmol/l) that is found to be the reference range. However, cardio - and cerebrovascular risk increases linearly with increasing Lp(a) levels even at Lp(a) values below 50 mg/dl (125 nmol/l). Higher levels of Lp(a)...

Migraine and comorbidities

doc. MUDr. Vladimír Nosáľ, PhD., FESO, doc. MUDr. Štefan Sivák, PhD.

Neurol. praxi. 2021;22(5):410-415 | DOI: 10.36290/neu.2021.083  

Migraine is associated with several comorbidities. The most important comorbidities are mentioned. Basic supposed pathomechanisms are shortly discussed together with specific migraine treatment with regards on present comorbidity.

Parents' experience of health care provided to children with epilepsy

Mgr. Jana Trtílková, PhDr. Lucie Klůzová Kráčmarová, Ph.D., prof. Ing. Mgr. Peter Tavel, Ph.D.

Neurol. praxi. 2021;22(5):416-420 | DOI: 10.36290/neu.2020.068  

The purpose of the project Health Talk is to provide publicly available information on how people experience various illnesses. This qualitative research offers insights into experiences of parents who have children with epilepsy in the area of specialized health care. The qualitative content analysis is based on 32 in-depth interviews with parents of children with epilepsy of children aged 0 to 18 years using the DIPEx method. The results show that parents evaluate subjectively their experiences with health care based on their experiences with the doctor's and medical staff's attitude (communication, humanity, patience) and based on the amount and...

Cauda equina syndrome in a different light

MUDr. Dušan Ospalík, MUDr. Ing. David Černík, Ph.D., MBA, Mgr. Iveta Ospalíková

Neurol. praxi. 2021;22(5):422-423 | DOI: 10.36290/neu.2020.051  

We report a case of a patient with clinical symptoms resembling cauda equina syndrome, however, with a negative finding on imaging studies. Due to severe pain and progressive limb weakness, a series of examinations were performed based on which dermatomyositis was suspected. Despite intensive care and causal treatment with corticoids, the patient expired. Histopathological changes characteristic for polyarteritis nodosa were observed postmortem. Polyarteritis nodosa is a rare disease which may be neglected in the differential diagnosis for inflammatory myopathies.

What are patients talking about on social networks?

doc. MUDr. Irena Doležalová, Ph.D., prof. MUDr. Milan Brázdil, Ph.D.

Neurol. praxi. 2021;22(5):425-429 | DOI: 10.36290/neu.2021.086  

During an encounter with the epilepsy patient, as doctors we often confine ourselves to the number of seizures and effect of treatment adjustment. We may thus sometimes miss the essential, which is the patient himself or herself and his or her problems. On the other hand, patients are often reluctant to confide in "a stranger face to face" in more detail. Recently, a new on-line space has emerged in which patients share their stories relatively fearlessly. When analysing this "new world", we can encounter views and attitudes which are interesting and inspiring for the doctor, as well as learn from our shortcomings here. This article has been inspired...

Samuel Alexander Kinnier Wilson (1878-1937), or copper, basal ganglia, chelates, and a new textbook concept

prof. MUDr. Petr Kaňovský, CSc., FEAN, doc. MUDr. Kateřina Menšíková, Ph.D., FEAN

Neurol. praxi. 2021;22(5):432-438 | DOI: 10.36290/neu.2021.100  

Samuel Alexander Kinnier Wilson (1878-1937) was a British neurologist of American (actually of Scottish-Irish) ancestry. He was born in New Jersey, but when one year old his mother brought him to Edinburgh in her native Scotland. Here, he completed both secondary and medical school. After graduation in 1902, he worked as a house officer at the Edinburgh Royal Infirmary where he spent one year; afterwards, he worked in neurology wards in Paris and Leipzig for three years. In 1905, upon his return to Britain, he joined the National Hospital for the Paralysed and Epileptic, Queen Square, London. In 1912, Wilson was appointed assistant physician at the...